Cancer remains one of the most formidable challenges in global health, characterized by immense biological complexity, heterogeneity, and resistance to conventional therapies. Despite significant advances in molecular biology and immuno-oncology, limitations in early detection, targeted delivery, and therapeutic precision continue to hinder effective management. Over the past two decades, nanotechnology has emerged as a transformative platform, offering novel strategies for both cancer diagnostics and treatment. Engineered nanomaterials—ranging from liposomes and polymeric nanoparticles to quantum dots and metallic nanostructures—enable precise tumor targeting, enhanced imaging resolution, and controlled therapeutic release. In diagnostics, nanoscale biosensors and imaging probes have revolutionized the sensitivity and specificity of biomarker detection and visualization, while in therapeutics, nanocarriers have minimized systemic toxicity and improved pharmacokinetics. Recent innovations, including smart and stimuli-responsive nanoplatforms, nanorobotics, and integrated “theranostic” systems, are reshaping personalized cancer care. However, translational hurdles persist, particularly in large-scale manufacturing, biosafety, and regulatory validation. This review critically examines the evolution of nanotechnology in oncology, emphasizing current applications, clinical progress, and future prospects toward achieving precision nanomedicine in cancer diagnosis and therapy.